Toxicology & Antidotes Flashcards
initial overdose management
topical = rinse w/ soap/water 10min
eyes = rinse for 15min
oral = remove from mouth, drink water/milk
inhaled = move to fresh air
eating button batteries = 2tsp honey Q10min
Ipecac syrup…
induces vomiting but is no longer recommended for use
Activated Charcoal
most effective when given within 1hr of ingestion of drug
dosing is 1g/kg
usually only one dose is given
4 phases of Acetaminophen OD
Phase 1: 1-24hrs, asymptomatic or non-specific symptoms, N/B
Phase 2: 24-48hrs, hepatotoxicity evident in labs (inc INR, AST/ALT)
Phase 3: 48-96hrs, fulminant hepatic failure
Phase 4: > 96hrs, pt recovers or gets liver transplant
Acetaminophen OD treatment
NAC = N-acetylcysteine
use Rumack-Matthew nomogram to determine need
Oral = 1 high dose, then 17 lower doses, repeating of vomit within 1hr of admin
IV = 3 infusions over 21hrs
Anticholinergic OD txm
supportive care, rarely use physostigmine
Antipsychotics OD txm
supportive care
benztropine for dystonias
bicarb if QRS interval widening
Benzo OD txm
Flumazenil
Beta-blocker OD txm
Glucagon
Calcium channel blocker OD txm
Glucagon + calcium (IV only)
Cyanide OD txm
Hydroxocobalamin
Digoxin OD txm
Digoxin Immune Fab (DigiFab)
Ethanol OD txm
Vitamin B1 to prevent Wernicke’s
Heavy metal OD txm (arsenic, copper, gold, lead, mercury, thallium)
Dimercaprol = arsenic, gold, mercury
DMSA = lead
Ferric Hexacyanoferrate “Prussian blue” = thallium
Penicillamine = Copper
Petrol product OD txm (gas kerosene, mineral oil, paint thinners)
dont make them throw-up, keep NPO
